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DEFINITION OF DIABETES:

The word derives from the greek διαβαßνειν Diabetes, which means "pass through" and identifies some diseases characterized by polyuria (excessive secretion of urine) and polydipsia (abundant ingestion of water).

 Diabetes is a metabolic change resulting in a decrease of activity of the hormone insulin. In particular, diabetes can be due to a reduced availability of this hormone, to an impediment to its normal action, or a combination of both factors.

A characteristic always present in diabetes mellitus is hyperglycemia, which with the passage of time, tend to associate certain complications of blood vessels: the macroangiopathy (ie particularly severe and early atherosclerosis), which is not specific of the diabetic disease , and microangiopathy (ie changes in movement of small arterial vessels which become particularly manifest in the retina, kidney, and nerve), which is instead of the specific pathology.


DIABETES MELLITUS:

The Diabetes Mellitus or DM comprises a group of metabolic disorders in common the fact of presenting a persistent instability of the blood glucose level of the blood, passing from conditions of hyperglycemia more frequently, in conditions of hypoglycemia. Although the term diabetes refers to the common practice on the sole condition of diabetes mellitus (so named by the ancient Greeks to the presence of sweet urine), there is another condition called diabetes insipidus. These diseases are united only by the fact of having copious amounts of urine, not submitting it causes or other symptoms are common.


DIABETES INSIPIDUS:

Diabetes insipidus is a rare syndrome characterized by large emission of urine, accompanied by an insatiable thirst with preference for cold drinks. E 'due to a lack of or inadequate secretion of antidiuretic hormone (ADH or vasopressin) from the posterior hypothalamus and pituitary, or its non-activity in the kidney


CURIOSITY 'RELATING TO DIABETES:

The first written relative to diabetes is dated 1500 BC on an Egyptian papyrus Ebers.

Was Aretaeus of Cappadocia in 100 A.D. approximately to describe the details of the pathology.

The first division with regard to the two main types of diabetes (type 1 and type 2) was performed by Avicenna (980-1037) around the year 1000.

In the Middle Ages in Europe the doctors' diagnosis of DM literally tasting the urine of patients, this practice can still be appreciated in a variety of works of art of the Gothic period.


DISCLOSURE OF DIABETES:

Diabetes mellitus is a common disease. In the U.S. are reported each year about 200,000 new cases of diabetes mellitus and the percentage of the world population affected by the disease is estimated to be 5%, with a slightly higher prevalence in women (about 25% more than males). The prevalence of diabetes mellitus in Italy is 3%. It increases with age, ranging from 0.5% in the age groups below 30 years up to 10% or more above the age of 65.



TYPES OF DIABETES:

The classification of the forms of diabetes currently recognized internationally divides it into:

Type 1 diabetes
, represented for nearly all of the shape immune-mediated (ie mediated by dysregulation of the immune system of the subject),


Type 2 diabetes
, instead due to a deficiency of insulin secretion by the cells of the pancreas or to the condition of tissue resistance to the action of insulin itself. About 90% of the diabetic population suffers from type 2 diabetes, while only a minority is affected by type 1 diabetes.



Diabetes of 1


Characterized by destruction of pancreatic B-cells (CD4 + and CD8 + cells and infiltration of macrophages in the pancreatic islets), usually resulting in binding to insulin deficiency.


There are two subforms:
  • Type 1A (immune-mediated)
  • Type 1B (idiopathic), but the etiology is unknown, affects mostly young Africans and Asians aged less than other form.

Comprises only 5-10% of all forms

It covers about 10% of people with diabetes and usually occurs in childhood or adolescence. In type 1 diabetes, the pancreas does not produce insulin due to the destruction of the beta cells that produce this hormone is therefore necessary that it be injected every day for life. The rate of destruction of ß-cells, however, is quite variable, so the onset of illness may be rapid in some people, usually in children and adolescents, and more slowly in adults (in those rare cases we speak of a particular form, said LADA: Late Autommune Diabetes in Adults).

The cause of type 1 diabetes is unknown, but characteristic is the presence in the blood of antibodies directed against antigens present at the level of the insulin-producing cells, said ICA, GAD, IA-2, IA-2SS. This damage, which causes the immune system against the insulin-producing cells, may be related to environmental factors (among them, have been implicated dietary factors) or to genetic factors, identified in a general predisposition to react to external events including viruses and bacteria. This hypothesis is based on studies in monozygotic twins (identical) that have allowed us to demonstrate that the risk of developing both type 1 diabetes is 30-40%, while it falls to 5-10% in non-twin siblings and 2 -5% in children. It may, therefore, transmit a "disease susceptibility" through the transmission of genes that affect the immune response and that, in the course of a trivial immune system's response to common infectious agents, also cause a reaction towards the beta cells of the pancreas, with the production of antibodies directed against them (auto-antibodies). This altered immune response causes a progressive destruction of ß cells, for which the insulin can no longer be produced and is unleashed so the diabetic disease.


Type 2 diabetes


A non-immune pathogenesis. It is related to the presence of genes in the vicinity of the site HLA on chromosome 6.
It is also known as non-ketotic.
Has a genetic basis more solid of the first, although the mode of transmission is not known.


Includes almost the totality of cases, 90-95% of all forms.



RISK FACTORS:


Among the risk factors are found:
 
  • Obesity
  • Physical inactivity.
  • Hypertension (SBP greater than or equal to 140 mmHg and or DBP greater than or equal to 90 mmHg)
  • HDL cholesterol (less than or equal to 35 mg / dl)
  • Triglycerides (greater than or equal to 250 mg / dl)

Even the age favors the onset of diabetes, because it is accompanied by a physiological reduction of the sensitivity of peripheral tissues to insulin.


SYMPTOMS OF DIABETES:

The symptoms you experience:

  • Hyperglycemia
  • Dyspepsia
  • Polyuria
  • Polydipsia (secondary to polyuria)
  • Paradoxical polyphagia (the patient eats a lot but slimming), often the presenting symptom is the diabetic ketoacidosis, present mainly in the form of type1
  • Weight loss
  • Nausea
  • Vomit
  • Fatigue, and irritability.
  • Asthenia
  • Headache
  • Paresthesias
  • Skin ulcers
  • Necrobiosis lipodica diabeticorum
  • Acanthosis nigricans
  • XerodermiaItch
  • Xanthelasma and xanthoma


The second form is often asymptomatic.



How to Prevent Diabetes    


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